
| Name | Value |
|---|---|
| NAME | POUCH,EAKIN,WOUND,FISTULA DRAINAGE C#8392-66 |
| VA GENERIC NAME | POUCH |
| DOSAGE FORM | POUCH |
| NATIONAL FORMULARY NAME | POUCH POUCH |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | POUCH,EAKIN,WOUND,FISTULA C#8392-66 |
| VA PRODUCT IDENTIFIER | XJ120 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4037077 |
| EFFECTIVE DATE/TIME |
|